Provider Demographics
NPI:1619340379
Name:INNER STRENGTH ACUPUNCTURE&PHYSICAL THERAPY
Entity Type:Organization
Organization Name:INNER STRENGTH ACUPUNCTURE&PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KYOUNG
Authorized Official - Middle Name:
Authorized Official - Last Name:SEO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-318-9041
Mailing Address - Street 1:11108 WOODSON AVE
Mailing Address - Street 2:
Mailing Address - City:KENSINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20895-1607
Mailing Address - Country:US
Mailing Address - Phone:301-318-9041
Mailing Address - Fax:301-942-2024
Practice Address - Street 1:4829 WEST LN
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-5317
Practice Address - Country:US
Practice Address - Phone:301-318-9041
Practice Address - Fax:301-942-2024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-03
Last Update Date:2015-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD23597261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy